颈前路治疗脊髓型颈椎病的手术选择
脊髓型颈椎病,,脊髓型颈椎病;手术;治疗,1临床资料,2结果,3讨论,参考文献:
摘要:[目的]探讨了32例脊髓型颈椎病(CSM)患者行颈前路手术的选择。[方法]]对32例非手术治疗无效的脊髓型颈椎病患者,根据临床和影像学因素选择实施不同的颈前路手术,分别行单间隙椎间盘切除融合术、椎体次全切除减压融合固定术、椎体次全切+单间隙椎间盘切除融合术、2个椎体节段的椎体次全切,其中2例3节段的CSM患者Ⅱ期行颈后路椎板切除融合内固定术。[结果]32例术后随访2~28 a,平均22 a。术后按贾连顺的临床功能评估示优良率为9375%。[结论]须根据CSM患者的临床和影像学因素采用不同的颈前路手术,对多节段病变的患者必要时Ⅱ期辅以颈后路手术。关键词:脊髓型颈椎病;手术;治疗
Surgical selection of anterior approachs for cervical spondylotic myelopathy∥TAN Junming,YE Xiaojian,YUAN Wen,et al
Department of Orthopaedics,The 98th Hospital of PLA,Huzhou,Zhejiang 313000
Abstract:[Objective]To discuss the surgical selection of anterior approachs for cervical spondylotic myelopathy(CSM)in 32 cases[Method]Thirtytwo cases of CSM without responding to nonoperative treatment were managed to different types of surgical techniques by anterior approch according to each patients specific clinical and radiographic scenarioAnterior decompression procedures consists of anterior cervical discectomy and fusion(ACDF),onelevel or twolevel corpectomy,hybrid ACDF and corpectomy procedures and two singlelevel corpectomies separated by a noncorpectomy levelTwo patients with threelevel disease had been performed posterior laminectomy and segmental fusion after 6 months of anterior procedure[Result]The duration of followup averaged 22 years(ranged,2~28 years)According to Jias criteria of functional assessment,9375% satisfactory rate was obtained[Conclusion]Selection of the appropriately anterior decompression and fusion is based on a complete understanding of the factors responsible for patients clinical situations and imaging resultsThe addition of posterior segmental fusion to an anterior decompression and fusion procedure should be considered in cases of multilevel(three or more)diseases of CSM with two stages of 6month intervals when necessary ......
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